February 4, 2014

on being a nurse . . . new grad edition, part one

Let me tell you a story . . . a story about being a new graduate nurse.

It all started, well, a long time ago. I will just begin when I graduated nursing school with honors, proud of my GPA, excited about starting life in the "real world." (I'm pretty sure my mom said something like - the world is your oyster!)
I had landed what I thought was my dream job, I was about to move back to my hometown and was just all around enthusiastic.

I had a vision of this next chapter of my life and it went something like this:

Living a glamorous life as a young professional in the city . . . I would have a beautiful apartment all to myself, I would not only adore my job in the ICU, but I would excel at it because of my GPA. My patients would all be calm, quiet and well-behaved. I would love my field so much that in my spare time, I'd read books and journal articles on critical care. I would float through this season with confidence, grace and ease.

You could say that I was a little bit idealistic.

Turns out life after college was a much bigger transition than I had anticipated.

When I started my new job, I had the support of my family and a close friend from college who was also living in the area, but I hadn't found my social niche quite yet. That is another challenge - finding friends and community after college. But I digress.

Remember the vision of how my life as an ICU nurse was going to be?

Enter the real world. I had about 12 weeks of one-on-one training with an experienced nurse (also called a preceptor) before I was going to be cut loose. I had never worked in a hospital before, or even worked a 12-hour shift.

All at once, I was learning how to be a nurse, learning how to be a critical care nurse, and just trying to figure out life in the "real world" in general. Overwhelming was an understatement.

I remember those first weeks in the hospital. I was no longer in my safe, comfortable bubble that I had when I was working as a medical assistant in a clinic in Wilmington.

I found myself in an unfamiliar, unpredictable, uncomfortable, overwhelming world. The doors to the ICU used to make this daunting click! click! sound as they unlocked and swung open every time you swiped your badge to enter the unit. Cue my adrenaline.

I quickly realized that I didn't just need a good GPA, or book smarts - I needed experience and judgement and critical thinking skills to fly here.

When you're a new graduate nurse, you go through this insanely steep learning curve. Week two, I was in full blown reality shock (and that's legit one of the stages of the curve). I remember thinking . . . "What have I done? I went to school for this? really?"

In this new environment I was eager to learn and do well, but at the same time I was very insecure, quiet and shy. My preceptor was exactly the opposite. I don't think I will ever forget her.

Those dreams of my patients being quiet and well behaved all went out the window when I met one of my first patients.

Ms. Patient was riding her bike to work when she was struck by a truck, and acquired multiple fractures as well as a head injury.

The thing about head injuries . . . they can make you confused, lose your short term memory, change your personality, cause you to become impulsive . . .

About the fifth time she yelled out into the hall, my preceptor told me that it was my turn to go into the room, and re-orient her ("You were in an accident, you're in the hospital, you're OK, etc")

She was laying in the bed with her eyes closed, banging her arm on the side rail and hollering, "open the door!!"

I gently said, "You're in a hospital bed, you're not in a car . . . there is no door."

*golden silence for 30 seconds*

*rattling of side rail re-commences*

"open the window!!!!"

. . . this is gonna be a long night.

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